4%, 84.9%, and 74.9%, respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 77.9%, 47%, and 38.9%, respectively. S-CLM located in the left liver (=.04), S-CLM KRAS mutation (&lt;.01), and extra-hepatic recurrence (&lt;.01) were identified as independent poor risk factors for overall survival (OS); the OS and DFS were comparable in patients with surgical procedure or percutaneous MWA.
In eligible S-CLM cases, percutaneous MWA seems to be as oncologically efficient as surgical resection and should be include in the decision-tree for treatment strategies.
In eligible S-CLM cases, percutaneous MWA seems to be as oncologically efficient as surgical resection and should be include in the decision-tree for treatment strategies.Formula-derived standard liver volume (SLV) has been clinically used for living donor liver transplantation and hepatic resection. The majority of currently available SLV formulae are based on body surface are (BSA). However, they often show a wide range of error. Skeletal muscle index measured at the third lumbar vertebra level (L3SMI) appears to reflect lean body mass. The objective of this study was to compare the accuracy of L3SMI-based formula and BSA-based formula for calculating SLV.
The study cohort was 500 hundred living liver donors who underwent surgery between January 2010 and December 2013. Computed tomography images were used for liver volumetry and skeletal muscle area measurement.
The study cohort included 250 male and 250 female donors. Their age, BSA, L3SMI, and body mass index were 26.8±8.7 years, 1.68±0.16 m, 45.6±9.0 cm/m, and 21.7±2.5 kg/m, respectively. The BSA-based SLV formula was "SLV (ml)=-362.3+901.5×BSA (m) (r=0.71, r=0.50, &lt;0.001)". The L3SMI-based SLV formula was "SLV (ml)=471.9+14.9×L3SMI (cm/m) (r=0.65, r=0.42, &lt;0.001)". Correlation coefficients were similar in subgroup analyses with 250 male donors and 250 female donors. There was a crude correlation between L3SMI and body mass index (r=0.51, r=0.27, &lt;0.001).
The results of this study suggest that SLV calculation with L3SMI-based formula does not appear to be superior to the currently available BSA-based formulae.
The results of this study suggest that SLV calculation with L3SMI-based formula does not appear to be superior to the currently available BSA-based formulae.In the last two decades, pancreatic cancer has been undergoing important changes in its perioperative management due to the great interest in multidisciplinary management and preoperative multimodal therapy, which in numerous studies have shown promising clinical results. Although the standard of treatment for resectable pancreatic ductal adenocarcinoma (PDAC) today is surgery followed by adjuvant therapy, as it is a biologically aggressive disease, even with complete resection, it has high rates of local and distant relapse. Several retrospective and prospective phase I/II studies have opened the window for neoadjuvant therapy with chemotherapy (CT), chemoradiotherapy (CRT), or both, as an alternative treatment for resectable pancreatic cancer, with promising results. Neoadjuvant therapy could has some advantages, including early administration of systemic treatment, in vivo assessment of response to treatment, increase resectability rate in borderline patients, increase resection rate with negative margin and survival benefit. While it seems clear that even potentially resectable disease would benefit from preoperative multimodal therapy, the optimal neoadjuvant therapeutic strategy is still controversial and currently there are only recommendations for neoadjuvant treatment, in clinical guidelines such as the NCCN and ESMO, for borderline and/or locally advanced PDAC. This review provides an overview of recent studies available and how they relate to systemic treatment of resectable PDAC in the neoadjuvant setting.Post-hepatectomy liver failure (PHLF) is a serious complication following liver resection, with limited treatment options, and is associated with high mortality. There is a need to evaluate the role of systems that support the function of the liver after PHLF.
The aim of this study was to review the literature and summarize the role of liver support systems (LSS) in the management of PHLF. Publications of interest were identified using systematically designed searches. Following screening, data from the relevant publications was extracted, and pooled where possible.
Systematic review identified nine studies, which used either Plasma Exchange (PE) or Molecular Adsorbent Recirculating System (MARS) as LSS after PHLF. Across all studies, the pooled 90-day mortality rate was 38% (95% CI 9-70%). However, there was substantial heterogeneity, likely since studies used a variety of definitions for PHLF, and had different selection criteria for patient eligibility for LSS treatment.
The current evidence is insufficient to recommend LSS for the routine management of severe PHLF, with the current literature consisting of only a limited number of studies. There is a definite need for larger, multicenter, prospective studies, evaluating the conventional and newer modalities of support systems, with a view to improve the outcomes in this group of patients.
The current evidence is insufficient to recommend LSS for the routine management of severe PHLF, with the current literature consisting of only a limited number of studies. There is a definite need for larger, multicenter, prospective studies, evaluating the conventional and newer modalities of support systems, with a view to improve the outcomes in this group of patients.Hepatic Artery Aneurysm (HAA) is a rare disease, but it can be a life-threatening pathology if it is ruptured. Multi-Detector Computed Tomography has to be considered the "gold standard" diagnostic imaging in detecting HAA and it is essential for treatment planning. Treatment for HAA can be surgical or endovascular. Endovascular approaches in HAA, compare to conventional abdominal surgery, benefit in less invasive treatments. https://www.selleckchem.com/products/pf-06463922.html The aim of our paper is to emphasize the three possible endovascular therapeutic techniques in HAA packing embolization, isolation embolization and stenting deployment.